Chinese puzzle

Weigh up the options ... researcher Dr Xiaoshu Zhu at the
University of Western Sydney.PHOTO: Simon Alekna

Paula GoodyerOctober 5, 2006 - 11:18AM

Western medicine can't always explain how it works, but
treatments from the East are gaining acceptance.

Faced with acute pain, most people head for the nearest
hospital. For many chronic conditions, however, more than 5 per
cent of Australians now use traditional Chinese medicine, according
to Professor Charlie Xue, head of the division of Chinese Medicine
at the RMIT University.

Western medicine is some way from wholeheartedly embracing
traditional Chinese medicine (TCM), but there have been moves to
incorporate aspects of it. "When I came to Australia from China 12
years ago, the medical profession didn't want to know about Chinese
medicine, but now it's more open-minded," Xue says.

In Xue's case, this open-mindedness has seen his treatments
incorporated into an emergency medicine setting. "My team now
provides acupuncture to treat patients in pain at the emergency
department at Melbourne's Northern Hospital - if we'd
suggested this 10 years ago, people would have laughed at us."

The World Health Organisation has acknowledged the role such
medicine plays in health treatments, and in 2002 launched a
strategy to gather more evidence on its safety and efficacy. That
same year, Australia's first Chinese Medicine Clinical Research
Centre opened in Liverpool Hospital to run clinical trials of
herbal medicine and acupuncture for gynaecological problems.

The trials included research into the effect of Chinese herbs on
endometriosis. Sydney policewoman Gina*, 32, took part in the
trials and, after a decade of debilitating period pain, no longer
juggles her shifts to ensure her time off coincides with her
periods.

"The first period I had after taking the herbs was much less
painful, and by the second month, there was no pain at all," she
says. "It's been life-altering."

Meanwhile, with two unsuccessful attempts at in vitro
fertilisation, only one functioning fallopian tube and her 41st
birthday looming, Joanne Day wasn't optimistic about
conceiving - especially when a doctor diagnosed problems with
her new partner's sperm.

"The specialist said the only way we'd conceive was with IVF, but I
didn't want to go through that again," says Day, who instead
consulted Jann Mehmet, a TCM practitioner in Rozelle. After a few
months of regular acupuncture and a healthier diet, she conceived
at 41 and had a baby at 42.

"The word is out that acupuncture can treat muscular-skeletal
problems, irregular periods, coughs and colds, infertility and many
other conditions," says North Shore practitioner Melissa Scott.

"At first people came as a last resort. Now we find that people who
have success with Chinese medicine often come with subsequent
problems, rather than go to a GP first. What draws many people is
that they're wary of the side effects of some Western
medication.

"Drugs are often Band-Aids that treat symptoms but not the
underlying cause - with eczema, for instance, you can be given
cortisone to reduce inflammation but it doesn't address the cause.
TCM on the other hand can help by strengthening the immune system
and digestive function."

Few Western-trained doctors refer patients to a TCM practitioner,
though one doctor now refers children with eczema to Scott for
pediatric massage - an alternative to acupuncture for children
who are afraid of needles.

The barriers to more doctors referring patients for TCM include
lack of registration - only Victoria has a registration system
for its practitioners - and lack of evidence for its
benefits.

Still, Xue says, it is the subject of increasing study and there's
some evidence that acupuncture helps treat headaches, period pain,
back pain and chemotherapyinduced nausea and vomiting. Studies
suggest it may improve IVF's success, though it's unclear why.

"It may increase blood flow to the uterus," says Dr Caroline Smith,
who has conducted a study of acupuncture and IVF through the
University of Adelaide. "It needs more research, but we know
acupuncture does no harm and may increase women's chances of
success."

As for Chinese herbal medicine, its acceptance lags behind
acupuncture, which now attracts a Medicare rebate provided it's
done by a medical doctor trained in acupuncture.

But Australian research has found that Chinese herbs can slow
liver damage caused by hepatitis C, and animal studies at Sydney's
Garvan Institute of Medical Research suggest a Chinese herb,
berberine, shows promise for diabetes by helping to
reduce blood sugar levels.

At the University of Technology, Sydney, trials of a Chinese herbal
formula in rats has found it reduces the risky symptoms of
metabolic syndrome - pot belly, high blood pressure, high
blood fats and insulin resistance.

Evidence to support TCM is building, yet its mystique persists
because it's hard to find Western medical explanations for how it
works. Unlike Western medicine, which often reduces the cause of
illness to a specific organ or system in the body, TCM attributes
disease to an imbalance affecting many different parts of the body.
It holds that good health depends on a strong flow of an energy
source called "chi" coursing through meridians or pathways in the
body - we get sick when pathways become blocked, preventing
the flow of chi.

This may have its own logic - but X-rays can't detect a
blocked meridian and there's no test to measure chi. But Western
medicine could explain why some research suggests acupuncture may
improve polycystic ovarian syndrome, the hormonal disorder
affecting 5 to 10 per cent of Australian women.

With this disorder, "the levels of male hormones are increased,
disrupting menstruation and fertility," says Dr Danforn Lim of the
faculty of medicine at the University of NSW, who is studying the
use of acupuncture to treat the syndrome. "Studies have found
acupuncture helps menstruation and fertility return to normal."

This may be due to acupuncture's effect on a part of the brain
called the hypothalamus. Research suggests acupuncture raises
levels of betaendorphins, the body's natural pain-killers produced
by the hypothalamus, which controls the hormone-regulating
pituitary gland, Lim explains.

As for the effects of herbal medicine on period pain, about 55
trials from Japan, Taiwan and China say it's effective, says
researcher Dr Xiaoshu Zhu, of the Centre for Complementary Medicine
Research at the University of Western Sydney.

According to Chinese medicine, herbs work by clearing blocked
meridians and strengthening the reproductive system, she says, but
a Western explanation might be that they have an effect on
hormones, relax uterine muscles or reduce prostaglandins, chemicals
thought to cause period pain.

There are parallels in Chinese and Western medicine, Zhu says, but
"you can't always make sense of Chinese medicine in Western
medicine terms".

As with others trained in both practices, she believes learning
both gives practitioners more skills to draw on. Or as Xue says,
"Neither is perfect - but if we can get the best of both
worlds, we get the best for patients."

* Name has been changed

Find a reputable practitioner

There is no independent regulator in NSW, although practitioners
are pressing for a formal registration system like Victoria's
Chinese Medicine Registration Board. Dr Chris Zaslawski, director
of the College of Traditional Chinese Medicine at UTS, suggests
word of mouth or checking with a reputable professional association
such as the Australian Acupuncture and Chinese Medicine
Association.

TCM practitioners are trained to be alert for signs that
could mean serious illness, he says, but without access to the same
diagnostic tools as Western physicians there is a risk of a delayed
diagnosis.

Working in a drug rehabilitation unit, Sydney acupuncturist
Christine Berle worked with people who had hepatitis C - the
chronic viral disease infecting the livers of 242,000 people in
Australia, and causing 16,000 new infections annually. When her
patients went for routine tests after a few weeks of acupuncture,
their liver function had dramatically improved.

Now Berle, a postgraduate student at UTS, is conducting a trial
to see whether 12 weeks of acupuncture has any effect on liver
function in people with hepatitis C. The drug treatment available
to clear the virus does not work for everyone.

Anyone interested in joining the trial at the UTS Traditional
Chinese Medicine Clinic, Broadway, or at Berle's practice in
Guildford, should phone 9632 8989.

When you see news happening: SMS/MMS: 0406 THE AGE (0406 843 243), or us. More